TY - JOUR
T1 - Improved Survival in Liver Transplant Patients Receiving Prolonged-release Tacrolimus-based Immunosuppression in the European Liver Transplant Registry (ELTR)
T2 - An Extension Study
AU - all contributing centers (www.eltr.org) and the European Liver and Intestine Transplant Association (ELITA)
AU - Adam, René
AU - Karam, Vincent
AU - Cailliez, Valérie
AU - Trunečka, Pavel
AU - Samuel, Didier
AU - Tisone, Giuseppe
AU - Němec, Petr
AU - Soubrane, Olivier
AU - Schneeberger, Stefan
AU - Gridelli, Bruno
AU - Bechstein, Wolf O
AU - Risaliti, Andrea
AU - Line, Pal-Dag
AU - Vivarelli, Marco
AU - Rossi, Massimo
AU - Pirenne, Jacques
AU - Klempnauer, Jurgen L
AU - Rummo, Aleh
AU - Di Benedetto, Fabrizio
AU - Zieniewicz, Krzysztof
AU - Troisi, Roberto
AU - Paul, Andreas
AU - Vali, Toomas
AU - Kollmar, Otto
AU - Boudjema, Karim
AU - Hoti, Emir
AU - Colledan, Michele
AU - Pratschke, Johan
AU - Lang, Hauke
AU - Popescu, Irinel
AU - Ericzon, Bo-Goran
AU - Strupas, Kestutis
AU - De Simone, Paolo
AU - Kochs, Eberhard
AU - Heyd, Bruno
AU - Gugenheim, Jean
AU - Pinna, Antonio D
AU - Bennet, William
AU - Kazimi, Mirjalal
AU - Bachellier, Philippe
AU - Wigmore, Stephen J
AU - Rasmussen, Allan
AU - Clavien, Pierre-Alain
AU - Hidalgo, Ernest
AU - O'Grady, John G
AU - Zamboni, Frausto
AU - Kilic, Murat
AU - Duvoux, Christophe
PY - 2019/9/1
Y1 - 2019/9/1
N2 - BACKGROUND: We compared, through the European Liver Transplant Registry, long-term liver transplantation outcomes with prolonged-release tacrolimus (PR-T) versus immediate-release tacrolimus (IR-T)-based immunosuppression. This retrospective analysis comprises up to 8-year data collected between 2008 and 2016, in an extension of our previously published study.METHODS: Patients with <1 month follow-up were excluded; patients were propensity score matched for baseline characteristics. Efficacy measures included: univariate/multivariate analyses of risk factors influencing graft/patient survival up to 8 years posttransplantation, and graft/patient survival up to 4 years with PR-T versus IR-T. Overall, 13 088 patients were included from 44 European centers; propensity score-matched analyses comprised 3006 patients (PR-T: n = 1002; IR-T: n = 2004).RESULTS: In multivariate analyses, IR-T-based immunosuppression was associated with reduced graft survival (risk ratio, 1.49; P = 0.0038) and patient survival (risk ratio, 1.40; P = 0.0215). There was improvement with PR-T versus IR-T in graft survival (83% versus 77% at 4 y, respectively; P = 0.005) and patient survival (85% versus 80%; P = 0.017). Patients converted from IR-T to PR-T after 1 month had a higher graft survival rate than patients receiving IR-T at last follow-up (P < 0.001), or started and maintained on PR-T (P = 0.019). One graft loss in 4 years was avoided for every 14.3 patients treated with PR-T versus IR-T.CONCLUSIONS: PR-T-based immunosuppression might improve long-term outcomes in liver transplant recipients than IR-T-based immunosuppression.
AB - BACKGROUND: We compared, through the European Liver Transplant Registry, long-term liver transplantation outcomes with prolonged-release tacrolimus (PR-T) versus immediate-release tacrolimus (IR-T)-based immunosuppression. This retrospective analysis comprises up to 8-year data collected between 2008 and 2016, in an extension of our previously published study.METHODS: Patients with <1 month follow-up were excluded; patients were propensity score matched for baseline characteristics. Efficacy measures included: univariate/multivariate analyses of risk factors influencing graft/patient survival up to 8 years posttransplantation, and graft/patient survival up to 4 years with PR-T versus IR-T. Overall, 13 088 patients were included from 44 European centers; propensity score-matched analyses comprised 3006 patients (PR-T: n = 1002; IR-T: n = 2004).RESULTS: In multivariate analyses, IR-T-based immunosuppression was associated with reduced graft survival (risk ratio, 1.49; P = 0.0038) and patient survival (risk ratio, 1.40; P = 0.0215). There was improvement with PR-T versus IR-T in graft survival (83% versus 77% at 4 y, respectively; P = 0.005) and patient survival (85% versus 80%; P = 0.017). Patients converted from IR-T to PR-T after 1 month had a higher graft survival rate than patients receiving IR-T at last follow-up (P < 0.001), or started and maintained on PR-T (P = 0.019). One graft loss in 4 years was avoided for every 14.3 patients treated with PR-T versus IR-T.CONCLUSIONS: PR-T-based immunosuppression might improve long-term outcomes in liver transplant recipients than IR-T-based immunosuppression.
U2 - 10.1097/TP.0000000000002700
DO - 10.1097/TP.0000000000002700
M3 - Article
C2 - 31343568
SN - 0041-1337
VL - 103
SP - 1844
EP - 1862
JO - Transplantation
JF - Transplantation
IS - 9
ER -